2014; Volume 15, No 7, July
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
Curative" treatments and palliative care: the lack of consensus
Current Opinion in Oncology | Online – 19 May 2014 – A survey was performed to assess whether authors who report about palliative treatments or palliative care share a common understanding of "curative" treatments. In the care for cancer patients, unambiguous terminology is essential for the participatory and interdisciplinary decision-making process. Clinicians, researchers and policy makers should be aware of the difference between curative and disease-modifying therapies. Otherwise, this may be a major source of misunderstandings as disease-modifying therapy may be indicated in the incurable stages of the disease as well. In these palliative situations, it is essential to identify the realistic aim(s) of the therapy: prolongation of life, alleviation of suffering or both. Of 107 authors from publications about cancer who used both "palliative" and "curative" in the same abstract, 42 (39%) responded. The majority [survey respondents] understood "curative" treatments as "aimed at complete absence of disease for the rest of life," but 43% did not share this view. For example, 19% stated that the term describes cancer-directed therapy for prolongation of life or even regardless of the aspired goal.
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The challenge to health professionals when careers resist truth telling at the end of life: A qualitative secondary analysis
Journal of Clinical Nursing | Online – 22 May 2014 – Staff [i.e., study participants] reported a hiding of the truth by carers and sustained use of activities aimed at prolonging life. Carers frequently ignored the advance of end of life, and divergence between staff and carer approaches to truth-telling challenged professionals. Not being truthful with patients had a deleterious effect on staff, causing anger and feelings of incompetence. Both children's and adult specialist palliative care staff found themselves caught in a dilemma, subject to policies that promoted openness in planning for death and informal carers who often prevented them from being truthful with patients about terminal prognosis. This dilemma had adverse psychological effects upon many staff.
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New European consensus on palliative care in neuro disease
Medscape Medical News | Online – 3 June 2014 – A new consensus paper for palliative care for patients with progressive neurologic disease emphasizes the special needs of these patients and how neurologists and palliative care specialists can work together to fulfill them. One of the authors, David Oliver, a geriatrician at Wisdom Hospice and consultant in palliative medicine at the University of Kent, U.K., said that for progressive and disabling neurologic diseases without curative treatment, palliative care aims to relieve pain and other distressing symptoms and to affirm life while regarding dying as a normal process. It should neither hasten nor postpone death and should integrate the psychological and spiritual aspects of patient care. The paper, presented at the [recent] meeting of the European Neurological Society, is the product of a joint effort of the European Federation of Neurological Societies and the European Association for Palliative Care. In the face of little evidence-based information in this area, the joint task force decided to issue what it called a consensus document "based on the available evidence" rather than a guideline.
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"I beg your pardon?" – Nurses' experiences in facilitating doctors' learning process: an interview study
Patient Education & Counseling | Online – 19 June 2014 – Working alongside specialized palliative care nurses brings about learning opportunities for general practitioners. The views of these nurses toward their role as facilitator of learning is unknown. The aim of this study is to clarify the views and preferences of these nurses toward their role as facilitator of physicians' learning. First, all interviewees shared the conviction that patient care is their core business. Secondly, two core themes were defined: nurses' preferences toward sharing knowledge and their balancing between patient care and team care. Combining these themes yielded a typology of nurses' behavioral style: the clinical expert-style, the buddy-style, the coach-style and the mediator-style.
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Media Watch is intended as an advocacy and research tool. The weekly report, published by Barry R. Ashpole, a Canadian communications consultant and educator, monitors the literature and the lay press on issues specific to the quality of end-of-life care. It is international in scope and distribution. Each month, this section of the IAHPC will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).
Access to the current and back issues of the weekly report.